DB107-Retroviral Replicating Vector (RRV) Combined With DB107-Flucytosine (FC) in Patients With Recurrent Glioblastoma or Anaplastic Astrocytoma

Trial Title: DB107-Retroviral Replicating Vector (RRV) Combined With DB107-Flucytosine (FC) in Patients With Recurrent Glioblastoma or Anaplastic Astrocytoma

NCT ID: NCT06264388

Condition: High Grade Glioma
Anaplastic Astrocytoma

Conditions: Official terms:
Glioblastoma
Astrocytoma
Flucytosine

Study type: Interventional

Study phase: Phase 2

Overall status: Recruiting

Study design:

Allocation: N/A

Intervention model: Single Group Assignment

Primary purpose: Treatment

Masking: None (Open Label)

Intervention:

Intervention type: Drug
Intervention name: DB107-RRV
Description: Patients will undergo surgery to remove as much of the high-grade glioma (HHG) tumor as possible and will receive combination intravenous (IV) and adaptive repeat intratumoral delivery of DB107-RRV in the vein (IV) and in the walls of the cavity that remains where tumor is removed.
Arm group label: DB107-RRV and DB107-FC Group

Intervention type: Drug
Intervention name: DB107-FC
Description: Patients will start taking DB107-FC three times by mouth every day for a period of seven days, which is one cycle of treatment. A cycle of treatment is medication taken on a set schedule with periods of rest in between. Patients will wait five weeks before taking the next seven day course of DB107-FC. The first dose of DB107-FC will be taken at the hospital or clinic; afterward, patients will take the doses of DB107-FC at home. Patients will take DB107-FC for up to 12 months after surgery.
Arm group label: DB107-RRV and DB107-FC Group

Other name: Ancobon

Other name: Ancotil

Summary: The purpose of this study is to determine if the investigational products, DB107-RRV and DB107-FC, as a combination treatment will shrink high-grade glioma (HGG) in patients with recurrent/progressive, resectable or unresectable disease and increase the time that disease is controlled.

Criteria for eligibility:
Criteria:
Inclusion Criteria: 1. Patients 18-75 years old. 2. Histologically proven HGG that have recurred/progressed (first or second recurrence). 3. Patients with unresectable or resectable HGG (AA or GBM) will be enrolled. 4. Measurable disease on MRI as evidenced by 1 cm on two separate dimensions on MRI fluid attenuated inversion recovery (FLAIR) (non-enhancing) or contrast-enhancement. 5. Last temozolomide dosage 4 weeks prior to surgery. 6. Patients with prior radiation therapy are allowed, but histological tumor diagnosis of recurrent tumor must be confirmed according to the RANO criteria. Recurrence must be confirmed by diagnostic biopsy with local pathology review or contrast-enhanced MRI. If first recurrence of GBM is documented by MRI, an interval of at least 12 weeks after the end of prior radiation therapy is required unless there is either: i) histopathologic confirmation of recurrent tumor, or ii) new enhancement on MRI outside of the radiotherapy treatment field. 7. Presence of Denovo Genomic Marker 7 (DGM7) biomarker in blood. 8. Laboratory values (Platelet count ≥ 80,000, hemoglobin [Hg] ≥10 g/dL, absolute neutrophil count (ANC) > 1,500 cells/mm3, absolute lymphocyte count (ALC) > 500/mm3) and adequate liver function, total bilirubin< 1.5 upper limit of normal (ULN), alanine transaminase (ALT) <2.5 ULN. Estimated glomerular filtration rate (eGFR) should be > 50 mL/min (Cockcroft Gault Formula). Patients with aspartate transaminase (AST) or ALT values >3 ULN and total bilirubin >1.5 mg/dL will be excluded. 9. Patients cannot be pregnant at the time of enrollment or during the study. Patients willing to use one (1) effective method of contraception in addition to barrier methods (condoms) from the time of signing the informed consent form until 12 months after receiving the last dose of DB107-RRV or until there is no evidence of DB107-RRV in their blood, whichever is longer. 10. Karnofsky Performance Score (KPS) ≥ 70. 11. Patient is able to consent and abide by protocol. Exclusion Criteria: 1. History of active other malignancy (other than non-melanoma skin cancers, cervical ductal carcinoma in situ or localized prostate cancer) within 5 years. 2. Multifocal gliomas that cannot undergo stereotactic biopsy/administration of DB107-RRV will be excluded. Patients with 3 or more intracranial recurrences will be excluded. 3. Histologically confirmed oligodendroglioma or mixed gliomas. 4. History of human immunodeficiency virus (HIV) infection or other forms of severe immunosuppression. 5. Patients with impaired renal function (eGFR<50 cc/min). 6. Patients with bone marrow depression, such as those with a hematological disease or who are being treated with radiation or drugs that depress bone marrow or individuals who have a history of treatment with drugs or radiation that depress bone marrow within 1 month of enrollment. 7. The patient intends to undergo treatment with the Gliadel® wafer at the time of this surgery or has received the Gliadel® wafer < 30 days from surgery. 8. Allergy to 5-FC. 9. Gastrointestinal diseases that prevent absorption of medications such as 5-FC. 10. Pregnancy or patients who are actively breast-feeding. 11. Recent use of cytosine arabinoside (< 3 weeks). 12. Recent treatment with bevacizumamab (< 3 weeks). 13. Recent treatment with temozolomide (<4 weeks). 14. History of bleeding diathesis or current anti-coagulant or anti-platelet usage, including nonsteroidal anti-inflammatory drugs (NSAIDs), at the time of the scheduled resection that cannot be stopped for surgery. 15. Sustained dependence on systemic dexamethasone (>8 mg/day) one month prior to surgery. 16. Severe systemic illnesses including cardiopulmonary dysfunction (New York Heart Association > Grade 2 congestive heart failure (CHF), uncontrolled arrhythmias, significant pulmonary disease > Grade 2 dyspnea) or other serious medical condition or social situations that in the judgement of the Investigator(s) would interfere or limit compliance with study requirements/treatments. 17. The patient has or had any active infection requiring systemic antibiotic, antifungal or antiviral therapy within the past 4 weeks. 18. Current or active coronavirus disease (COVID-19) disease, positive quantitative polymerase chain reaction (qPCR) result. 19. Patients with impaired decision-making capacity. 20. Patients who are currently receiving investigational medications or medical device(s) within 4 weeks (or 5 half-lives of the investigational medication(s), whichever is shorter) prior to enrollment. 21. Patients who have any other disease, either metabolic or psychological, which as per Investigator assessment may affect the patient's compliance or place the patient at higher risk of potential treatment complications.

Gender: All

Minimum age: 18 Years

Maximum age: 75 Years

Healthy volunteers: No

Locations:

Facility:
Name: University of Miami Hospital

Address:
City: Miami
Zip: 33136
Country: United States

Status: Recruiting

Contact:
Last name: Leonela Wright, MSN, RN

Phone: 305-243-0864
Email: lxw612@med.miami.edu

Contact backup:
Last name: Ashish Shah, MD

Phone: 305-243-6946
Email: ashah@med.miami.edu

Investigator:
Last name: Ashish Shah, MD
Email: Principal Investigator

Start date: May 1, 2024

Completion date: May 1, 2034

Lead sponsor:
Agency: Ashish Shah
Agency class: Other

Collaborator:
Agency: Denovo Biopharma LLC
Agency class: Industry

Collaborator:
Agency: National Cancer Institute (NCI)
Agency class: NIH

Source: University of Miami

Record processing date: ClinicalTrials.gov processed this data on November 12, 2024

Source: ClinicalTrials.gov page: https://clinicaltrials.gov/ct2/show/NCT06264388